An Intern's Perspective: Helping Tackle Global Health Challenges

I first thought about Coca-Cola availability
when I heard Melinda Gates at a TEDTalk in 2010, where she asks the simple
question, “if Coca-Cola can get their beverages to remote regions around the
world, why can’t governments and NGOs deliver social products such as medicines
and condoms with the same degree of success?” This talk was the inspiration for
Project Last Mile, in which Coca-Cola has entered into public-private
partnerships with ministries of health across Africa, sharing knowledge on
their distribution networks and delivery systems. The project was piloted in
Tanzania, and is currently expanding into Ghana and Mozambique. Through my
internship with The Coca-Cola Company in Johannesburg, South Africa, I was
tasked with preparing a concept paper on launching a similar project in South
Africa.

Within the public health field, there
is a fair amount of skepticism toward the notion of Coca-Cola engaging with the
health sector on issues that are admittedly outside of its core competency.
After all, medicines are incredibly different products from a bottle of
soda—they have to be handled differently and by specially trained people, as they
have temperature-sensitive transportation requirements and strict expiration
dates. I’ll admit I was skeptical at first that this was nothing more of a
naïve proposal, instead of an innovative development solution.

But my skepticism quickly turned to
optimism when I had the opportunity to go onsite to Dar es Salaam, Tanzania,
and observe the results of the partnership directly. I held meetings with management
at Coca-Cola Kwanza (CCK—Coca-Cola’s in-country, Tanzanian-owned bottling company),
and the Medical Stores Department (MSD—Tanzania’s government-run department responsible
for the warehousing and delivery of essential medicines throughout the
country), in an effort to understand the project’s challenges, opportunities,
and successes. What I learned is that the project has not involved any medical
products being placed on Coca-Cola trucks. Instead, it is strictly about sharing
knowledge of CCK’s management processes with MSD. Like many public sector
institutions in developing countries, before the intervention MSD suffered from
the lack of a clear incentive structure to drive performance. Roles within the
organization were not clearly defined, and central management had little
control of what went on in district clinics and medical depots, resulting in
frequent stock-outs of essential medicines. Meanwhile, just 10 kilometers down
the road from MSD, Coca-Cola Kwanza is a tightly run ship. A performance-driven
culture is motivated by a system of financial incentives for employees, demand
forecasts for product are fed upstream by a meticulous data department, and
route optimization is calculated by logistics experts with state-of-the-art
mapping software.

Project Last
Mile has paired various members of MSD with a member of CCK in a similar
function for trainings and mentoring. I think what drives the success of this
model is that the mentors at CCK are Tanzanians themselves—local people who
know and understand local markets, local roads, and local systems. Route to
market optimization experts at CCK give training to MSD personnel on their
mapping and supply chain management software; human resources personnel give
training on their performance monitoring processes; and planning personnel at
MSD receive training from demand forecasters at CCK. One of the most incredible
things for me to witness was that MSD had implemented a performance monitoring
system modeled after CCK’s in which employees’ salaries will be adjusted
according to performance reviews, and incredible innovation for a public sector
entity in a developing country.

Meanwhile, back in South Africa,
I’ve visited some of the more remote and rural regions where major
inefficiencies plague the drug delivery system. In the country with the highest
HIV burden per capita in the world, reliable delivery of ARVs is a life and
death matter. Yet recent
reports have detailed that stock-outs in rural clinics throughout the country
are common. In many rural depots, order forms are rarely correctly completed by
pharmacists, paper delivery receipts don’t reach the central office to monitor
delivery and stock supply, boxes of medicines are left open on the floor and
not correctly warehoused, and demand is not forecasted in any meaningful way.
In contrast, Coca-Cola’s South African bottler uses mobile technology to feed
upstream data back to its central offices on every bottle of Coca-Cola
delivered to its endpoint. This data is time- and GPS-stamped, such that a
manager in a regional plant can tell you where any bottle of Coca-Cola for his
region is at any given moment. The opportunities for collaboration on sharing
this knowledge are immense.

Perhaps the most interesting lesson
from observing the Last Mile partnership is that this project is not about outsourcing a key
responsibility of the public sector to a private company. Rather, it is about
sharing knowledge of the strengths of a private sector entity and its
efficiencies with the public sector in order to strengthen public systems and professionalize
the civil service. If development is primarily about improving systems, then
partnerships such as this one just might be the necessary solution.

Peter Cook is
currently pursuing a master's degree in Global Human Development from
Georgetown University. Peter just finished up
an internship with The Coca-Cola Company in Johannesburg, South Africa, working
on a variety of global sustainability projects. The Coca-Cola Company is an internship partner of
Georgetown University’s Global Human Development program.